Risk scores are statistical indicators based on prescribing patterns compared to specialty peers. They are NOT allegations of fraud, misconduct, or improper care. Many legitimate medical reasons can explain outlier prescribing.
Read our methodology →Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
883
Total Claims
$3.1M
Drug Cost
190
Beneficiaries
$16K
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+639%
Opioid rate vs peers
16.5% vs 2.2% avg
+1051%
Cost per patient vs peers
$16K vs $1,411 avg
+135%
Brand preference vs peers
25.0% vs 10.6% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid prescribing rate is 639% above the average for Internal Medicine providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 1051% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
16.5%
Opioid Rate
146
Opioid Claims
$4,742
Opioid Cost
24.7%
Long-Acting Rate
Brand vs Generic
Brand: 221 claims · $2.9M
Generic: 662 claims · $158K
Patient Profile
74
Avg Age
54%
Female
2.79
Avg Risk Score
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Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About